Assessment of the postoperative effect of corneal cross-linking on keratoconus using the ABCD grading system

Kasumović, Aida; Matoc, Ines; Kasumovic, Armin; Sabol, Ivan; Radman, Ivana; Krolo, Ivan

doi:10.4103/ijo.ijo_368_21

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…In the literature, only a few studies evaluated the applicability of the ABCD staging system in monitoring the efficacy of the standard procedure. In contrast, only one recently published retrospective study investigated its utility in evaluating accelerated protocols and compared the effectiveness of different protocols regarding the ABCD grading system [ 8 , 39 , 40 , 41 , 42 , 43 ]. Danesh and coauthors showed no significant changes in parameters A and D, while parameters B and C significantly increased one year after conventional CXL [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effect of Conventional Versus Accelerated Corneal Cross-Linking Protocol on Corneal Geography and Stability

Vidas Pauk,

Jandroković,

Lešin Gaćina

et al. 2023

Medicina

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Purpose: To determine the 6-month effect of conventional (CXL30) and accelerated cross-linking with a UVA intensity of 9 mW/cm2 (CXL10) on corneal stability and to investigate whether there was a difference in ABCD grading system parameters regarding the two different procedures. Methods: Twenty-eight eyes of 28 patients with a documented keratoconus (KN) progression were included. Patients were selected to undergo either epi off CXL30 or CXL10. At the baseline and the follow-up visits after one (V1), three (V2), and six months (V3), the patients underwent complete ophthalmic examination and corneal tomography. Results: In the CXL30 group, all the parameters from the ABCD grading system significantly changed from baseline to V3; parameter A decreased (p = 0.048), B and C increased (p = 0.010, p < 0.001), and D decreased (p < 0.001). In the CXL10 group, there were no changes in parameters A (p = 0.247) and B (p = 0.933), though parameter C increased (p = 0.001) and D decreased (p < 0.001). After an initial decline after one month, visual acuity (VA) recovered on V2 and V3 (p < 0.001), and median maximal keratometry (Kmax) decreased in both groups (p = 0.001, p = 0.035). In the CXL30 group, there were significant changes in other parameters; average pachymetric progression index (p < 0.001), Ambrósio relational thickness maximum (ARTmax) (p = 0.008), front and back mean keratometry (p < 0.001), pachymetry apex (PA) (p < 0.001), and front elevation (p = 0.042). However, in the CXL10 group, there were significant changes only in ARTmax (p = 0.019) and PA (p < 0.001). Conclusion: Both epi-off CXL protocols showed similar short-term efficacy in improving VA and Kmax, halting the progression of KN, and both similarly changed tomographic parameters. However, the conventional protocol modified the cornea more significantly.

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Section: Discussionmentioning

confidence: 99%

Short-Term Effect of Conventional Versus Accelerated Corneal Cross-Linking Protocol on Corneal Geography and Stability

Vidas Pauk,

Jandroković,

Lešin Gaćina

et al. 2023

Medicina

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Clinical outcome of intrastromal corneal ring segment implantation with two different nomograms in keratoconus patients

Mounir,

Saghir,

Radwan

et al. 2024

Delta Journal of Ophthalmology

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Aim The aim of this study was to assess the clinical effects of Keraring implantation in patients with keratoconus (KC) using a newly created nomogram (NN) based on cone location and Q value compared with the manufacturer’s standard nomogram (SN). Patients and methods This is a prospective randomized controlled clinical trial that included 100 keratoconic eyes of 100 patients. The patients were randomly assigned into two groups: group NN and group SN. Group NN underwent Keraring implantation based on the newly developed nomogram, while group SN followed the manufacturer’s standard nomogram. The primary outcome measures included visual acuity, different refractive measurements, keratometry values, and Q values, while the secondary outcome measure was Belin ABCD KC grading. All outcome measures were evaluated at 12 months postoperatively. Results The mean age of group NN was 22.96±7.45 years and that of group SN was 24.12±7.00 years, with no statistically significant difference (P=0.46). At 3 months postoperatively, group NN demonstrated substantial improvements compared with group SN. Group NN exhibited a greater improvement in uncorrected distance visual acuity [mean difference (MD) in LogMAR visual acuity=−0.61 compared with −0.31 in group SN, P<0.0001] and corrected distance visual acuity (MD: −0.34 LogMAR compared with −0.05 LogMAR in group SN, P<0.0001). Significant reductions were noted in sphere (MD: 4.22 D in group NN compared with 2.33 D in group SN, P<0.0001), refractive cylinder (MD: 2.87 D in group NN compared with 1.74 D in group SN, P=0.003), and spherical equivalent (MD: 5.56 D in group NN compared with 3.12 D in group SN, P<0.0001). Keratometric values and Belin ABCD grading system (particularly A and D categories) also showed more pronounced improvements in group NN than in group SN (P<0.0001). Conclusion The personalized approach of the new nomogram (NN) based on cone location and Q value resulted in superior visual, refractive, and corneal topographic outcomes compared with the standard nomogram (SN) during the implantation of Keraring in KC patients. The individualized nomogram allowed for more precise corneal reshaping and restoration of corneal asphericity.

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Assessment of the postoperative effect of corneal cross-linking on keratoconus using the ABCD grading system

Cited by 2 publications

References 28 publications

Short-Term Effect of Conventional Versus Accelerated Corneal Cross-Linking Protocol on Corneal Geography and Stability

Short-Term Effect of Conventional Versus Accelerated Corneal Cross-Linking Protocol on Corneal Geography and Stability

Clinical outcome of intrastromal corneal ring segment implantation with two different nomograms in keratoconus patients

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